Individual
DIANA L KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
28 EDWARD AVE APT B, EDGERTON, WI 53534-1949
(608) 884-4441
Mailing address
28 EDWARD AVE APT B, EDGERTON, WI 53534-1949
(608) 884-4441
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313323-031
WI
Other
Enumeration date
02/14/2011
Last updated
02/14/2011
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